Chythar Skyfire/Medical History: Difference between revisions

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===PAST MEDICAL HISTORY===
===PAST MEDICAL HISTORY===
*'''Chronic Illnesses:'''
*'''Chronic Illnesses:''' None
*'''Medications:'''
*'''Medications:''' None
*'''Allergies and Reactions:'''
*'''Allergies and Reactions:''' None
*'''Sexual/Reproductive History:'''
*'''Sexual/Reproductive History:''' None
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|style="background:teal;"|
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===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
===PAST HOSPITALIZATIONS/SERIOUS ILLNESS===
*'''SD 237005.05:'''
*'''SD 237005.05:'''

Revision as of 00:08, 5 May 2014

Starfleet Medical.png

SKYFIRE, CHYTHAR DANIEL

  • Patient Reference Number:198-461-762
  • Date of Birth:236207.06
    • Age: 39
  • Sex:M
  • Species:Human
MEDICAL RECORD
  • Height: 167.64 cm (5'5" in)
  • Weight: 65 kilos (143.30 lbs)
  • Blood Type: B+ (B Positive)

PAST MEDICAL HISTORY

  • Chronic Illnesses: None
  • Medications: None
  • Allergies and Reactions: None
  • Sexual/Reproductive History: None

PAST HOSPITALIZATIONS/SERIOUS ILLNESS

  • SD 237005.05:
  • SD 237007.05:

PAST SURGICAL HISTORY

  • SD 237005.05:
  • SD 237007.05:

PSYCHIATRIC HISTORY

SUBSTANCE USE HISTORY

  • Alcohol:
  • Recreation Drugs:
  • Other:

FAMILY MEDICAL HISTORY

  • Mother:
  • Father:
  • Siblings:

SOCIAL HISTORY

  • Marital status:
  • Children:
  • Occupation/Assignment:
  • Diet:
  • Exercise:

PHYSICIANS' NOTES

  • Medical Officer:
  • Medical Assessment:

COUNSELORS' NOTES

  • Counselor:
  • Psychological Assessment:
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